Healthcare Provider Details

I. General information

NPI: 1417745969
Provider Name (Legal Business Name): TARA JANE SAYER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARA JANE GLANDORF RN

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8860 NORTHPARK DR STE 200
URBANDALE IA
50131-3168
US

IV. Provider business mailing address

8860 NORTHPARK DR STE. 200
URBANDALE IA
50131-3168
US

V. Phone/Fax

Practice location:
  • Phone: 515-724-0377
  • Fax:
Mailing address:
  • Phone: 515-724-0377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number116304
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: